摘要
[目的]探讨癌组织中 SEPT9 基因甲基化水平对Ⅱ～Ⅲ期可切除直肠癌患者术后无进展生存期的影响.[方法]129 例均行 R0 全直肠系膜切除术治疗的Ⅱ～Ⅲ期可切除直肠癌患者,术后随访 5 年.检测并比较患者癌组织、癌旁组织中 SEPT9 基因甲基化阳性表达情况,分析患者癌组织中 SEPT9 基因甲基化水平与临床病理参数的关系,分析影响直肠癌术后复发或转移的因素,探讨癌组织中 SEPT9 基因甲基化阳性表达与患者术后无进展生存的关系.[结果]癌组织中 SEPT9 基因甲基化阳性表达率高于癌旁组织(P＜0.05).低分化、N2 期、Ⅲ期、肿瘤浸润脉管的可切除直肠癌患者癌组织中 SEPT9 基因甲基化阳性表达率分别高于中、高分化及 N0～N1 期、Ⅱ期、肿瘤未浸润脉管者(P＜0.05).Cox回归分析显示:术前癌胚抗原水平、病理分期、分化程度、SEPT9 基因甲基化阳性是影响患者术后复发或转移的独立因素(P＜0.05).SEPT9 基因甲基化阳性表达患者的无进展生存率低于阴性表达患者(P＜0.05).[结论]Ⅱ～Ⅲ期可切除直肠癌患者癌组织中 SEPT9 基因甲基化水平与临床病理参数及预后有关,SEPT9 基因甲基化阳性表达患者术后复发、转移风险更高.
Abstract
[Objective]To investigate the impact of SEPT9 gene methylation level in cancer tissues on pro-gression-free survival after surgery in patients with stage Ⅱ-Ⅲ resectable rectal cancer.[Methods]A total of 129 patients who underwent R0 total mesorectal excision for stage Ⅱ-Ⅲ resectable rectal cancer were fol-lowed up for 5 years postoperatively.The positive expression of SEPT9 gene methylation in cancer tissues and adjacent non-cancerous tissues was compared,and the relationship of SEPT9 gene methylation levels in cancer tissues with clinicopathological parameters was analyzed.Factors affecting postoperative recurrence or metasta-sis of rectal cancer were investigated,along with the relationship between positive expression of SEPT9 gene methylation in cancer tissues and progression-free survival after surgery.[Results]The positive expression rate of SEPT9 gene methylation in cancer tissues was higher than that in adjacent non-cancerous tissues(P＜0.05).Patients with poorly differentiated,N2 stage,stage Ⅲ,and tumor invasion into the vasculature had higher positive expression rates of SEPT9 gene methylation in cancer tissues than those with moderately to well-differentiated,N0-N1 stage,stage Ⅱ,and no tumor invasion into the vasculature(P＜0.05).Cox re-gression analysis showed that preoperative carcinoembryonic antigen levels,pathological staging,differentia-tion degree,and positive SEPT9 gene methylation were independent factors affecting postoperative recurrence or metastasis(P＜0.05).Patients with positive expression of SEPT9 gene methylation had lower progression-free survival rates than those with negative expression(P＜0.05).[Conclusion]The level of SEPT9 gene methylation in cancer tissues of patients with stage Ⅱ-Ⅲ resectable rectal cancer is related to clinicopatholog-ical parameters and prognosis.Patients with positive expression of SEPT9 gene methylation have a higher risk of postoperative recurrence and metastasis.
维普
万方数据